Associations between self-rated health, sickness behaviour and inflammatory markers in primary care patients with allergic asthma: a longitudinal study

Abstract

Allergic asthma is a chronic inflammatory disorder associated with elevated levels of immunoglobulin E (IgE), serum eosinophilic cationic protein (S-ECP), plasma eosinophil-derived neurotoxin (P-EDN) and fraction of exhaled nitric oxide (FENO). Poor self-rated health and sickness behaviour has repeatedly been associated with inflammatory markers, but the nature of this relationship in chronic inflammatory disease is not known. Likewise, such findings largely rely on cross-sectional investigations. Self-rated health (How would you rate your general state of health?), sickness behaviour (mean rating of satisfaction with energy, sleep, fitness, appetite and memory), IgE, S-ECP, P-EDN, and FENO were assessed in 181 non-smoking primary care patients with asthma in a 1-year longitudinal study. Associations between repeated measurements were calculated using mixed regression models and Spearman’s correlations for change scores. Poor self-rated health was associated with high levels of seasonal IgE (p = 0.05) and food IgE (p = 0.04), but not total IgE or inflammatory markers. An increase over 1 year in perennial IgE was associated with a worsening of self-rated health (ρ = 0.16, p = 0.04). Poor self-rated health was associated with more pronounced sickness behaviour (p < 0.001), and a worsening in sickness behaviour was associated with a worsening of self-rated health over time (ρ = 0.21, p = 0.007). The study corroborates the importance of sickness behaviour as a determinant of self-rated health by showing that these factors co-vary over a 1-year period in a group of patients with allergic asthma. The importance of specific IgE for perceived health in primary care patients with mild to moderate asthma needs further investigation.

Retrospective evaluation of the effects of Sugammadex and Neostigmine on the IgE and Eosinophil Cationic Protein in Morbid Obese Patients

“…1 , 2 )]. Although elevated levels of serum IgE and ECP can be seen in allergic patients or patients with an atopic constitution [ 11 , 16 ], no statistically significant increases were observed in the preoperative and postoperative levels of total IgE and ECP in this study. Besides, no bronchospasm or urticaria-like symptoms were observed clinically in none of the study groups.…”

Deleterious and Protective Psychosocial and Stress-Related Factors Predict Risk of Spontaneous Preterm Birth

“…Many of the findings described here are consistent with previous reports, and in the case of novel findings, are consistent with our a priori hypotheses that were based on what is known in the literature about the harmful effects of deleterious psychosocial factors and chronic stress on other health outcomes. 33 34 35 The logical consistency of our findings, their potential use for predicting adverse outcomes such as PTB, and their potential for impact in terms of identifying biological, psychological, and/or social targets for intervention, suggest that these findings merit further investigation.…”

“…It is noteworthy that even though a large number of factors were included in the analysis, raising important concerns about Type 1 error or false positive findings, there was not a single instance where the associations discovered were contrary to our a priori hypothesis or to what one would logically expect given published stress-related findings in the context of other health outcomes. 33 34 35 Nevertheless, we recognize the importance of replicating (and building on) these findings, which we will attempt to do in the context of additional subjects recruited as part of this study, and encourage other groups to attempt independently of this study.…”

Integrated behavioral health care for management of stress in allergic diseases

“…19 Perceived stress was associated with comorbidity between urticaria and allergies, 20 and high levels of food or seasonal allergies were associated with poor self-report health ratings in patients with allergic asthma, with self-report ratings of perceived overall health decreasing over time with increases in levels of seasonal allergies. 21 Additionally, a relationship has been found between high psychosocial stress and exacerbation of allergic disorders, 7 and psychological stress has an impact on persistent allergic rhinitis, with symptom improvement and increased quality of life when stress is treated and controlled. 22…”